The scapulothoracic bursa lies between the subscapularis muscle (on the costal scapular surface) and the serratus anterior muscle overlying the posterior chest wall. It is separate from the subscapular bursa at the front of the glenohumeral joint. In addition to this space, adventitial bursae can develop in response to scapulothoracic friction, especially at the superomedial angle of the scapula. The scapulothoracic joint is a physiological joint where the scapula glides smoothly on the chest wall during shoulder elevation.
| Location | Between the subscapularis on the costal surface of the scapula and the serratus anterior on the posterior chest wall (supraserratus space) |
|---|---|
| Nearby |
|
Allows the scapula to glide smoothly over the chest wall during scapular protraction, retraction and rotation
Scapulothoracic crepitus (scapular snapping) results from friction between the scapular undersurface and the chest wall, causing an audible and palpable snapping or grinding during shoulder elevation and protraction. This may be from an inflamed scapulothoracic bursa, a bony prominence (osteochondroma of the superomedial scapular angle or underlying rib), or muscle wasting creating bony prominence. Scapulothoracic bursitis is treated with scapular stabilisation exercises and ultrasound-guided corticosteroid injection between the serratus anterior and subscapularis. Surgical bursectomy and smoothing of the scapular angle treats refractory cases.
Scapulothoracic bursa inflammation or a bony prominence at the superomedial scapular angle produces a palpable and sometimes audible snap during shoulder elevation from impingement between the scapular undersurface and the chest wall; managed by bursal injection and physiotherapy, with surgical bursectomy and scapular angle reshaping for refractory cases.
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